Individual provider Active NPI

Kelly M. Christner, PA-C

  • Surgical Physician Assistant
  • Springfield, OR
National Provider Identifier
1154796878
Registry record updated Apr 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA179199 Issued in OR
Practice address
3355 Riverbend Dr Ste 300
Springfield, OR 97477-8800
Phone
(541) 868-9303
Fax
(541) 868-9306
NPI assigned
Dec 7, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA179199 OR Primary

Addresses

Primary practice location

3355 Riverbend Dr Ste 300
Springfield, OR 97477-8800

Mailing address

3311 Riverbend Dr Ste 300
Springfield, OR 97477-8800
Phone (541) 222-3531

Other identifiers 1

IdentifierTypeStateIssuer
500718575MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170119001716 OR Practitioner - Physician Assistant 7012299415 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PeacehealthGroup PAC ID 8527016039, 200 clinicians

Practice addresses (Care Compare)

2801 NW Mercy Dr
Suite 350
Roseburg, OR 97471-2349
Phone (541) 222-2700

3311 Riverbend Dr
Springfield, OR 97477-8800
Phone (541) 222-7218

3333 Riverbend Dr
Springfield, OR 97477-8800
Phone (541) 222-7300

3355 Riverbend Dr
Springfield, OR 97477-8800
Phone (541) 222-6113

Hospital & facility affiliations

  • Sacred Heart Medical Center - Riverbend Hospital, Springfield, OR, CCN 380102

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1449446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682640000000",
    "number": "1154796878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3311 RIVERBEND DR STE 300",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974778800",
            "telephone_number": "541-222-3531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3355 RIVERBEND DR STE 300",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974778800",
            "telephone_number": "541-868-9303",
            "fax_number": "541-868-9306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTNER",
        "first_name": "KELLY",
        "middle_name": "M.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-07",
        "last_updated": "2023-04-28",
        "certification_date": "2023-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OR",
            "license": "PA179199",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500718575",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, OR

Sources for this page

Verify at the official NPI Registry.